Monday, October 31, 2016

"Eighteen months after a donated liver from a stranger saved the life of Ottawa Senators owner Eugene Melnyk, his case has helped prompt Canadian transplant officials to accept that public pleas for living organ donors are ethical, legal and even beneficial, under the right circumstances.

Melnyk was one of two high profile cases in 2015 (the other was the family of twin girls from Eastern Ontario, the Wagners) in which public pleas were made for a liver donor. Hundreds of people answered the call to donate parts of their livers to save Melnyk’s life. His eventual transplant was a success and both Melnyk and his anonymous donor — who was described only as a Senator’s fan — recovered. Little Binh Wagner also recovered from a successful liver transplanted from an anonymous donor (her twin sister received part of their father’s liver).

The cases raised ethical questions about the fairness of public pleas that tend to favour those with more compelling stories over others legitimately waiting for an organ transplant. They also highlighted the fact that there is no national policy on organ solicitation, a gap the Canadian Society of Transplantation, the Canadian National Transplant Research Program and the Canadian Blood Services hope to close with guidelines released this week.

The guidelines acknowledge that ethical questions remain, but note that the gap between supply and demand of organs and the availability of public platforms to easily make such pleas means those questions are going to continue.

Dr. Atul Humar, medical director of transplant at the University Health Networks in Toronto where Melnyk’s and Binh Wagner’s transplants were performed, said public solicitations are increasing, mainly because of easy access to social media and a shortage of organs to transplant. Earlier this year, Gianna-Lynn Favilla, an eight-year-old Russell girl, received a life-saving liver transplant after the family made a desperate public plea on her behalf. The donor was a neighbour and the father of Gianna-Lynn’s best friend.

At the end of 2014, 4,514 patients (3,473 for a kidney and 507 for a liver) were waiting for an organ in Canada. During the same year, 2,356 transplant procedures were performed and 278 patients died while on the waiting list."
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"The issue has caused some soul searching among transplant officials in Canada and around the world. Some institutions have refused to transplant organs obtained from public solicitation and the practice is banned in Australia. Recently, European transplant officials came to a similar conclusion as the Canadian guidelines: “As long as donor shortage persists, we should not condemn patients, who do not have a live kidney donor, or only have a very slim chance of finding a suitable donor when they decide to publicly solicit for a live donor.”